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Workers' Compensation laws require employers to provide workers who have been injured on the job with equal access to medical treatment. Nevertheless, a recent study of Missouri workers found significant racial and socioeconomic differences in management of job-related low back injuries that were not accounted for by insurance differences. Workers who were black or of low socioeconomic status (SES) received fewer benefits than other workers, according to Raymond C. Tait, Ph.D., of St. Louis University School of Medicine.
With support from the Agency for Healthcare Research and Quality (HS13087), Dr. Tait and his colleagues used a Worker's Compensation database, worker self-report, and telephone interviews to examine differences in the case management of occupational low back injuries among 580 black and 892 white workers in Missouri. The workers had filed Workers' Compensation claims that had been settled over an 18-month period. They could not choose their initial health care provider, which equalized initial access to treatment. The injuries ranged from herniated disc and pinched nerve to fracture and degenerative joint disease.
Type of injury, race, age, and compensation rate significantly predicted whether a claimant did or did not receive temporary disability pay. Consistent with accepted models of disability management, claimants with disc injuries and those who underwent surgery incurred more treatment costs, had more compensated work absences, and demonstrated longer claim periods. They also received higher disability ratings and larger settlement awards. Other findings were not consistent with accepted disability management models. After controlling for injury and other factors, blacks and lower SES claimants incurred lower treatment costs, fewer compensated work absences, shorter claim periods, lower disability ratings, and smaller settlements.
More details are in "Management of occupational back injuries: Differences among African Americans and Caucasians," by Dr. Tait, John T. Chibnall, Ph.D., Elena M. Andresen, Ph.D., and Nortin M. Hadler, M.D., in the December 2004 Pain 112, pp. 389-396.
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